Hematology Unit, Yenimahalle Education and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey
Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey
Turk J Med Sci. 2020 Nov 3;50(SI-2):1697-1706. doi: 10.3906/sag-1911-112.
BACKGROUND/AIM: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been used for the treatment of various refractory solid tumors during the last two decades. After the demonstration of graft-versus-leukemia (GvL) effect in a leukemic murine model following allo-HSCT from other strains of mice, graft-versus-tumor (GvT) effect in a solid tumor after allo-HSCT has also been reported in a murine model in 1984. Several trials have reported the presence of a GvT effect in patients with various refractory solid tumors, including renal, ovarian and colon cancers, as well as soft tissue sarcomas [1]. The growing data on haploidentical transplants also indicate GvT effect in some pediatric refractory solid tumors. Novel immunotherapy-based treatment modalities aim at inducing an allo-reactivity against the metastatic solid tumor via a GvT effect. Recipient derived immune effector cells (RDICs) in the antitumor reactivity following allo-HSCT have also been considered as an emerging therapy for advanced refractory solid tumors.
This review summarizes the background, rationale, and clinical results of immune-based strategies using GvT effect for the treatment of various metastatic and refractory solid tumors, as well as innovative approaches such as haploidentical HSCT, CAR-T cell therapies and tumor infiltrating lymphocytes (TIL).
背景/目的:在过去的二十年中,异基因造血干细胞移植(allo-HSCT)已被用于治疗各种难治性实体瘤。在异体 HSCT 后来自其他品系小鼠的移植物抗白血病(GvL)效应在白血病小鼠模型中得到证实后,异体 HSCT 后在实体瘤中的移植物抗肿瘤(GvT)效应也于 1984 年在小鼠模型中得到报道。几项试验报告了在各种难治性实体瘤患者中存在 GvT 效应,包括肾、卵巢和结肠癌以及软组织肉瘤[1]。基于单倍体移植的不断增加的数据也表明在一些儿科难治性实体瘤中存在 GvT 效应。基于新型免疫疗法的治疗方法旨在通过 GvT 效应诱导对转移性实体瘤的同种异体反应。异体 HSCT 后抗肿瘤反应中的受体衍生免疫效应细胞(RDICs)也被认为是治疗晚期难治性实体瘤的一种新兴疗法。
本综述总结了利用 GvT 效应治疗各种转移性和难治性实体瘤的免疫策略的背景、原理和临床结果,以及同种异体 HSCT、嵌合抗原受体 T 细胞疗法和肿瘤浸润淋巴细胞(TIL)等创新方法。